Aislamiento pulmonar en pacientes con resecciones pulmonares previas: bloqueo lobular selectivo secuencial con bloqueador bronquial Fuji Uniblocker® / Lung isolation in patients with previous lung resections: Selective sequential lobar blockade using a Fuji Uniblocker® endobronchial blocker

El aislamiento pulmonar es obligado durante la cirugía torácica, al permitir la visualización y manipulación por parte del cirujano del pulmón intervenido. La aparición de hipoxemia durante el aislamiento pulmonar es habitual, y aún es más frecuente en aquellos pacientes con reserva funcional pulmonar disminuida. Presentamos 2 casos clínicos de pacientes con antecedentes de resección pulmonar previa izquierda (1.° lobectomía inferior izquierda y 2.° lobectomía inferior izquierda y segmentectomía del lóbulo superior izquierdo), en los que se realizó bloqueo lobular secuencial selectivo (BLSS), con BB Fuji Uniblocker® para la realización de resecciones atípicas de pulmón derecho (LSD, LM y LID). En nuestra experiencia la técnica fue satisfactoria, el campo quirúrgico fue óptimo y no registramos ningún tipo de complicación intra o postoperatoria derivada de su uso, pudiendo ser una alternativa al aislamiento pulmonar tradicional, en pacientes con función respiratoria comprometida (reserva funcional escasa o resecciones pulmonares previas) (AU)

Lung isolation is essential during thoracic surgery, as it allows the thoracic surgeon to visualise and work in the surgical field. The occurrence of hypoxaemia during lung isolation is common, and is even more so in patients with decreased pulmonary functional reserve. The clinical cases are presented of 2 patients with a history of left pulmonary resections (1st left lower lobectomy, 2nd left lower lobectomy and left upper lobe segmentectomy), in which sequential selective lobar blockade was performed with Fuji Uniblocker® endobronchial blocker for performing right lung atypical resections (right upper lobe, middle lobe, and right lower lobe). In our experience the technique was successful, the surgical field was optimal and no intra- or post-operative complications were found. This technique may be an alternative to traditional lung isolation in patients with compromised respiratory function (low functional reserve or previous contralateral lung resections) (AU)

Lung isolation in patients with previous lung resections: Selective sequential lobar blockade using a Fuji Uniblocker® endobronchial blocker. / Aislamiento pulmonar en pacientes con resecciones pulmonares previas: bloqueo lobular selectivo secuencial con bloqueador bronquial Fuji Uniblocker®.

Lung isolation is essential during thoracic surgery, as it allows the thoracic surgeon to visualise and work in the surgical field. The occurrence of hypoxaemia during lung isolation is common, and is even more so in patients with decreased pulmonary functional reserve. The clinical cases are presented of 2 patients with a history of left pulmonary resections (1st left lower lobectomy, 2nd left lower lobectomy and left upper lobe segmentectomy), in which sequential selective lobar blockade was performed with Fuji Uniblocker® endobronchial blocker for performing right lung atypical resections (right upper lobe, middle lobe, and right lower lobe). In our experience the technique was successful, the surgical field was optimal and no intra- or post-operative complications were found. This technique may be an alternative to traditional lung isolation in patients with compromised respiratory function (low functional reserve or previous contralateral lung resections).

[Assessing preoperative use of medicinal plants during preanesthetic interviews]. / Valoración del consumo preoperatorio de plantas medicinales en la consulta preanestésica.

OBJECTIVES: To assess the use of medicinal plant preparations in preanesthetic interviews at a Spanish university hospital. MATERIALS AND METHODS: A total of 500 questionnaires were randomly distributed over a period of 3 months to patients attending a preanesthetic assessment interview. RESULTS: Of the 431 valid questionnaires returned, 154 (35.73%) were from patients who reported consumption of some type of herbal remedy and 55 (12.76%) were from patients who used a medicinal plant considered in the literature to be potentially toxic. Consumption was higher among women (64.28%) (P < 0.001). Among users of these plants, 137 (88.96%) reported that they did not consider them to be medications and 141 (91.55%) would not have told the anesthesiologist about their use during a routine clinical interview. CONCLUSION: There is considerable use of medicinal herbs with potentially adverse interactions with various drugs used during the perioperative period. Anesthesiologists need to be familiar with such herbs and their effects and to ask specific questions about their use during the preanesthetic interview.

Valoración del consumo preoperatorio de plantas medicinales en la consulta preanestésica / Assesing preoperative use of medicinal plants during preanesthetic interviews

OBJETIVOS: Valorar el consumo de plantas medicinales en la consulta preanestésica de un hospital universitario español. MATERIAL Y MÉTODOS: Durante tres meses se llevaron a cabo un total de 500 encuestas repartidas de forma aleatoria en pacientes que acudían a consulta para valoración preanestésica RESULTADOS: De las 431 encuestas válidas, 35,73 % (154) de los pacientes encuestados afirmaron estar consumiendo algún tipo de planta medicinal y el 12,76% (55) afirmaron estar consumiendo alguna planta medicinal recogida en la bibliografía consultada como potencialmente tóxica. El consumo fue mayor en mujeres 64,28% (P<0,001). De los consumidores, 88,96% (137) no consideraban a las plantas medicinales como medicamentos y el 91,55% (141) no habría informado al anestesiólogo de su consumo durante una entrevista clínica rutinaria. CONCLUSIÓN: En la muestra estudiada el consumo de plantas medicinales con potenciales efectos adversos e interacciones farmacológicas con distintos fármacos utilizados habitualmente durante el periodo perioperatorio es importante. Es necesario que los anestesiólogos conozcan dichas plantas medicinales y sus efectos, e interroguen de forma específica sobre su consumo durante la consulta preanestésica

OBJECTIVES: To assess the use of medicinal plant preparations in preanesthetic interviews at a Spanish university hospital. MATERIALS AND METHODS: A total of 500 questionnaires were randomly distributed over a period of 3 months to patients attending a preanesthetic assessment interview. RESULTS: Of the 431 valid questionnaires returned, 154 (35.73%) were from patients who reported consumption of some type of herbal remedy and 55 (12.76%) were from patients who used a medicinal plant considered in the literature to be potentially toxic. Consumption was higher among women (64.28%) (P<0.001). Among users of these plants, 137 (88.96%) reported that they did not consider them to be medications and 141 (91.55%) would not have told the anesthesiologist about their use during a routine clinical interview. CONCLUSION: There is considerable use of medicinal herbs with potentially adverse interactions with various drugs used during the perioperative period. Anesthesiologists need to be familiar with such herbs and their effects and to ask specific questions about their use during the preanesthetic interview